Adolescents Who Make Suicide Attempts Consider Risks Differently

Jeffrey Bridge, Ph.D.

As part of an AFSP grant, Jeff Bridge, Ph.D., and his colleagues studied decision making in teenagers who have made a suicide attempt. He looked at how teens control their thoughts and behaviors, their levels of aggression and their tolerance for being provoked or frustrated. He compared the levels of impulsivity, aggression, and impulsive aggression in suicide attempters and similar youth who were in the same treatment programs and had not made a suicide attempt. The results were published in the April 2012 issue of the American Journal of Child & Adolescent Psychiatry.

The study included 40 adolescents aged 13 to 18 who had recently made a suicide attempt and 40 matched adolescents who had never made a suicide attempt. He collected data on the Iowa Gambling Task (IGT) a computerized gambling task that provides an evaluation of decision making. Participants also filled out questionnaires and were interviewed about their impulsiveness, aggression and their past and present psychiatric treatment.

Adolescents who had attempted suicide were less likely to learn how to maximize decision making in order to earn the most money compared to the other psychiatrically ill adolescents. Group differences in mood disorders, psychiatric medications, impulsivity and hostility did not account for their poor choices. They found no relationship between the poor decision-making performance and any characteristics of the attempt such as time since last suicide attempt, number of previous attempts, intent to die or medical consequences of the attempt. Overall, the results support other research that suggests inflexible decision making may play a role in increasing risk for suicidal attempts.

Dr. Bridge has used the data from his study to secure a five-year, $2.1 million research grant from the National Institute of Mental Health (NIMH), titled “Impulsive Aggression, Neurocognition, and Suicidal Behavior in Depressed Youth” that will start in July 2012. This work has the potential to help with the development of practical suicide risk evaluation tools, treatments and preventive interventions to reduce adolescent suicidal behavior.

An added benefit from Dr. Bridge’s AFSP grant was that Neel Koyawala, a senior at a local Columbus, Ohio high school, used data from Dr. Bridge’s AFSP grant to conduct an independent, mentored research project examining the relationship between sleep problems and adolescent suicidal behavior. According to Dr. Bridge, Neel’s results showed that self-reported sleep problems were associated with adolescent suicidal behavior, even after taking into account current antidepressant medication use, depression and being bullied. Neel submitted his study to the Young Epidemiology Scholars Program National Competition. In April 2011, he presented the findings in Washington, D.C. and finished in the top 12 (of 562) applicants, earning him a $15,000 scholarship. Neel is currently attending the University of Pennsylvania where he plans to study biochemistry.

Jeff Bridge, Ph.D., is an epidemiologist at the Center for Innovation in Pediatric Practice at Columbus Children’s Research Institute and an Associate Professor of Pediatrics the Ohio State University College of Medicine. He conducted this research with a Young Investigator Grant from AFSP.